HomeMy WebLinkAboutMortgage_Archer�
/
.¢""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun T �mshi Ye
FOR DEDUCTION FROM ASSESSED VALUATION
s�a Fo�,�.s�ae �ae i z-0��
S,,,, � Prasrnbed by Department at Lonl Govemmerrt Fi`ance A P R p
File Mark
INSTRUCTIONS: `—y,, �
To be filed in persun or by med wrth the CourMyAud'rtor dttre couirty where the properfy is bcafed. O��a� �
Fding Dates: 1 J Real Rnperty: During the 12 monMs be/ore Jwe 17 of the year Ure deduction is to be eAec6ve. (/
2) Mabile Homes assessed under IC 67.1-7: BeMeen January 75 errd March 2 of the }rear Me deduction �'���if�f4NTY A UDI70R
See reverse side for additional rnsWCtions end qualrficafions.
see
z�r� i;c�o - i a
piopaty as d March 1. nn�t year
If ro, whal is ha / her e�mQ share d�teresi?
IF72f�e m recad is differenl Ihan Ihat oF applicam, indi<
NarneoFrtungageearcorqradseller �/
/
/.
nm��s m monpagee «�vaa se��. (�„mee, ma �
Nartre of assgnee or otl� owner w hdder af mortgage
Address of assignee (nsMer erd sLcet. afY• state. ana
Does applicant own properry in arry ather
wuNy in Intliana? '
❑ Yes ❑ No
DeduUion eppmved in �he amwM of:
zo 0 9 zo
I / We certif�Undei
Indiana and owner
sigret�e (o�ers hi� n
-/8-�oa-000.,�oy_o� S'
Mwi�a9e / Con4atl indebtedness unptitl as of March 1.
�'R�'�` 7 I, �f o U
' I( amed with sonieme dhei
eeL aty, sfafe. erMLPCOde)
ZlP mJe)
�f,�s.,�,��� �
couNTVnuor
�_ � �
coimry
Rem�d
0
spouse. rtdicate with whom.
�%.59$
# BqUlUWB OMICr}
❑ Yes � No
1: ihe property in questim:
❑ Real Pmoertv O Moble Home (IC 61.
a�q........
Drawcr NO...........
�5�
ca��a �o . . ...................
.� '1 i �'f o�. °0�
20
zo
�� �
❑ No
zo
the panaijsi of perjury Mat Me above and foregoing infwrt�ation is We and mrtecl and that ihe appGpnCS was I were a resident of
of p�e aforementioned DroP�1Y � March 1, 20 •
pry, sfate, aM ZIP code)
S �(Y ; a� �is = �Q{�a
ny duy rxewied P�er or ur«r�ey w nr ic s-i.i
Pddress of authrn¢ed persm (num6er aM s4ee! cAy. state, and ZfP cude)
Dale (monfh. daY. Y��
oa�e (mmm, ear. r�d